105 The Professional Counselor | Volume 13, Issue 2 Discussion This study aimed to examine how counseling students conceptualize and propose treatment for the experience of TDV in both female and male clients. The results indicate that gender played a significant role in counseling students’ responses to a survivor’s clinical needs. Data were grouped using the following categories that corresponded with questions: (a) case conceptualization and clinical impressions, (b) diagnostic impressions, (c) relationship considerations, (d) practice considerations, (e) treatment approaches, and (f) gender bias. Within these categories, 19 themes emerged, which we discuss further below. The counseling students presented similar challenges in their case conceptualizations and diagnoses for each scenario. Sperry and Sperry (2020) noted that case conceptualization is essential for counseling students to inform clients of diagnostic, treatment, and clinical formulations. Many responses demonstrated counselor bias, limitations in practical skills and case conceptualization, and minimal depth of knowledge. As found in this study, there was a misdiagnosis of the client’s presenting issue as a mental health disorder and an overemphasis on comorbid symptoms (e.g., failing grades) instead of evaluating these phenomena as a response to the trauma (i.e., TDV). This failure to conceptualize clients accurately leads to improper diagnosis and ineffective treatment. Interestingly, although the study did not include a requirement to diagnose the fictitious clients, many of the participants still provided a diagnosis. In a systematic review of the literature, Merten et al. (2017) found that misdiagnosis and unintended overdiagnosis of mental health disorders in children and adolescents is likely more common than expected, leading to improper treatment. Qualitative research illuminates how cognitive information processing obscures diagnostic and clinical decisionmaking (Hays et al., 2009). This phenomenon, known as availability bias, is when clinicians determine the mental health status of clients based on personal experiences or stigma rather than the observable criterion. It is plausible that the counseling students in this qualitative study demonstrated availability bias (based on gender or age), inhibiting their future work with TDV in young clients. Further, the study’s findings show that many counseling students are unaware of evidence-based interventions to treat TDV appropriately. Students mentioned interventions like cognitive behavioral therapy (CBT), solution-focused therapy, couples counseling, and academic tutoring to reduce client distress and increase self-esteem. Although CBT is a viable treatment approach, none of the responses suggested the implementation of trauma-informed modalities or protocols (such as STAIR; American Psychiatric Association, 2019) for teens recovering from emotional and physical abuse. Traumainformed approaches focusing on empowerment and advocacy are incredibly powerful in healing relationship trauma (Ogbe et al., 2020). Most strikingly, the counseling students appeared to overlook many critical aspects of treating trauma survivors, including screening, risk assessment, safety planning, and psychoeducation (Ogbe et al., 2020). A promising aspect of this study is that some counseling students suggested peer support and group therapy as appropriate treatment responses for TDV. Research indicates that school-based peer groups can decrease the rate of abuse among middle and high school–aged students (Ball et al., 2015) and reduce physical dating violence following treatment (Temple et al., 2013). Studies also reveal higher success rates for the prevention of TDV when survivors perceive consistent emotional safety. Factors like school climate, group setting, peer interactions, perspectives on abuse, and opportunities for adaptive skills-building can contribute to survivor care (Ball et al., 2015).
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